Urinary Incontinence

WHAT YOU SHOULD KNOW:

Urinary incontinence (UI) occurs when you leak urine. Your bladder is an organ that stores urine until it leaves your body through your urethra. There are muscles around your urethra, called sphincter muscles, that keep your urethra closed. Normally, when your bladder is full the bladder muscle contracts (tightens), and the sphincter muscles relax and open. Once the sphincter muscles open, the urine can flow through your urethra and out of your body. With UI, you are not able to control when urine leaves your bladder. The most common types of UI are stress UI, urge UI, and mixed UI. With stress UI, you leak small amounts of urine with activities, such as exercising, sneezing, coughing, or lifting. With urge UI, you may feel the need to urinate right away, causing small or large urine leaks. You have mixed UI when you have both stress and urge UI.

UI may occur if you have weak bladder, pelvic, or sphincter muscles. You may have UI if your bladder has trouble storing and emptying urine, or if your bladder contracts too often. Your risk for UI increases if you are a female who has given birth, or you are elderly. Your risk also increases if you are overweight, take certain medicines, have had pelvic surgery or a spinal cord injury. Urine tests, a cough stress test, and tests to check the pressure in your bladder may diagnose your UI. Treatment may include medicines, exercises, or surgery to help support your bladder and improve bladder control. Treatment may decrease, or stop, urine leaks, and help you control when you urinate.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

The medicines used to treat UI may cause dry mouth, blurred vision, constipation, and confusion. During surgery, your bladder, urethra, or rectum may be damaged. Women having surgery are at risk for damage to the vagina. After surgery to treat your UI, you may have pain, bleeding, and bruising. You may get an infection in your surgery wound or urinary tract. The sling material used for surgery may break down or damage the vagina or urethra. Your urethra may narrow, you may have trouble urinating, feel strong urges to urinate, or keep leaking urine. If a balloon compression device was inserted during surgery, the balloon may move out of place or leak. If bulking agents are used, an abscess (pocket of infection) may form at the injection (shot) site.

If you do not get treatment for your UI, your urine leakage may get worse. You may leak larger amounts of urine, more often. The urine may cause your skin to become red and sore. You may get urinary tract infections often. Not being able to control when you urinate can interfere with your daily life. You may have trouble sleeping well if you wake often with a need to urinate. Elderly people are at risk for an injury from falling if they leak urine on the floor. Falls may also occur when hurrying to use the bathroom. Talk with your caregiver if you have questions or concerns about your treatment or care.

WHILE YOU ARE HERE:

Informed consent

is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

An IV (intravenous)

is a small tube placed in your vein that is used to give you medicine or liquids.

Anticholinergic medicine: Anticholinergic medicine is given to decrease how often your bladder contracts and causes you to leak urine.

Hormone therapy: Women who have reached menopause may need to take the hormone estrogen. Menopause occurs when a woman no longer has a monthly period. Estrogen may help improve bladder control.

Tests:

Urine sample: For this test you need to urinate into a small container. You will be given instructions on how to clean your genital area before you urinate. Do not touch the inside of the cup. Follow instructions on where to place the cup of urine when you are done.

Treatment options:

You may need any of the following treatments, depending on the type of UI you have:

Treatment for stress UI:

Bulking agents: Caregivers may give you an injection (shot) of a bulking agent, such as silicone, into the wall of your urethra. Bulking agents thicken the wall of your urethra to help keep your urethra closed and decrease urine leakage.

Surgery: Ask your caregiver for more information about the following:

Artificial urinary sphincter: During this surgery, your caregiver inserts an artificial (man-made) urinary sphincter (AUS) around your urethra. An AUS allows you to control when you urinate.

Bladder sling: During this surgery, a sling is placed around your bladder neck and urethra. Your bladder neck is where the bottom of your bladder and urethra connect. The sling is made of mesh or other man-made material. The sling may also be made of tissue from another area in your body. The sling supports your urethra and bladder neck, so you do not leak urine.

Colposuspension: During colposuspension surgery, your bladder and urethra are pulled up into a more stable position. Sutures (stitches) are placed into the bladder neck and secured to tissue or bone. The sutures support your urethra and bladder neck, so you do not leak urine.

Compression device: A compression device is made of two small balloons that are inserted on each side of your urethra. When the balloons are full, they squeeze your urethra closed, so no urine leaks out. You will empty the balloons when you need to urinate. Emptying and filling the balloons is done with a device implanted (under the skin) in the scrotum or labia. The scrotum is the sac of skin surrounding a man's testicles. The labia are pads of fat found on each side of a woman's vagina.

Treatment for urge UI:

Sacral nerve stimulation: Sacral nerve stimulation is done by implanting an electrical device in your body. The device has wires that are connected to the sacral nerves in your lower spine. The sacral nerves control your bladder and pelvic muscles. The device sends signals to your sacral nerves to help improve your bladder control.

Surgery: Ask your caregiver for more information about the following:

Bladder augmentation: Bladder augmentation is surgery to increase the size of your bladder so it will hold more urine. During surgery, a part of your intestine (bowel) may be removed and used to make your bladder larger.

Urinary diversion: During urinary diversion surgery, a new path is made for urine to exit your body.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.